Wednesday Medium Focused Program Ages 15-19

Name: Wednesday Medium Focused Program Ages 15-19
SKU: 65059
Availability: InStock

$100

Session

Clear

"*" indicates required fields

To be filled out by student (with help of an adult if needed)

This class requires an application of interest before being enrolled

Student Name*

Have you taken an art class before?*

First Choice

Second Choice

Third Choice

Can be here at FCAC, at school, or elsewhere

Do you have any prior experience with this medium? If so, what is an example of what you have made before?*

What do you hope to learn in this class?*

ex. new skills, improve my skills, history of the medium, etc.

Please upload any images of your art that relates to this art medium if you have any!

Drop files here or

Max. file size: 64 MB, Max. files: 3.

End of Student Application

Below should be completed by guardian

Interested in adding YAP Studio?

Yes! Please email me more information

Not at this time

YAP Studio is an open studio time for students already enrolled in other YAP classes. This time is for students to work on projects they may not have finished in class or want to develop further, use materials to work on their own creative projects, and be in a creative space with other students where they are not given a structured lesson. An art teacher will be present to provide access to materials and guide students if needed. There will be no step by step lesson or project planned.

Student's Date of Birth

How did you hear about the program?*

Notes for instructor

Behavioral, medical conditions, allergies, sensitivities, etc.

Contact Info

Primary Guardian Contact Info

First Last

Primary Guardian Phone Number*

Email*

We will send the invoice & class information to this email

Secondary Guardian Contact Info

First Last

Emergency contact if primary guardian cannot be reached

Secondary Guardian Phone Number

Adults who are allowed to pick up your child at the end of class.

Consent and Acknowledgement

In consideration of my/child’s participation in programs provided by First City Art Center, I indemnify and hold First City Art Center and its affiliates, employees and agents harmless from and against any and all liability for negligence or medical expenses resulting from my/child’s participation in such programs or other activities. I further release First City Art Center and its affiliates, employees and agents from any and all negligence or other claims resulting from my child’s participation. I further understand that First City Art Center does not provide medical insurance coverage for myself/child and that any medical expenses incurred will be paid by either my own medical insurance or myself. I hereby grant permission for my child to participate in all activities.

I give permission for my/child’s photo and/or likeness to be retained and used by First City Art Center without any remuneration or compensation.

I authorize FCAC staff to administer immediate and emergency medical treatment, including (1) transporting myself/child to a hospital emergency room or (2) calling the local rescue squad or ambulance.

Student Code of Conduct

Consequences include time out, notifying parents, and or in the extreme case removal from the program for the safety and well-being of all parties.

Physical harm to self or other campers
Conduct which constitutes harassment or bullying
Refusal to follow instructions to the point of threatening the safety of their-self or other campers.
Disrespectful behavior or language toward the instructors or other participants.
Theft of property
Intentional destruction of property.

Policy Agreement*

I Agree

In the field below indicate that you have read, understand, and agree to the Consent and Acknowledgment Terms and the Cancellation Policy.